3. Diagnostics & Assessments

what criteria are used to diagnose diabetes?

• A1C 6.5% or higher

• fasting plasma glucose 126 mg/dL or higher after at least 8 hours with no caloric intake

• 2-hour plasma glucose 200 mg/dL or higher during an oral glucose tolerance test

• symptoms of diabetes plus a random plasma glucose 200 mg/dL or higher

what fasting plasma glucose level diagnoses diabetes?

126 mg/dL or higher after at least 8 hours with no caloric intake

what 2-hour plasma glucose level diagnoses diabetes during an oral glucose tolerance test?

200 mg/dL or higher after a 75 g glucose load

what random plasma glucose level can diagnose diabetes when symptoms are present?

200 mg/dL or higher plus symptoms like polyuria, polydipsia, and unexplained weight loss

when should diabetes be confirmed with a second abnormal test result?

when hyperglycemia is not clearly obvious

what is A1C?

glycated hemoglobin that shows average blood glucose control over about 3 months

• glucose attaches to hemoglobin in RBCs and stays there for the life of the cell (about 3 months)

what makes the A1C level rise?

blood glucose being above normal for a long time

what is a normal A1C range?

4% to 6%

what is the diagnosis criteria for diabetes?

A1C of 6.5% or greater

what is the target A1C for most people with diabetes?

less than 7%

what should be assessed in the history of a patient with diabetes?

symptoms, glucose monitoring, adherence to the management plan

what should be checked on physical exam for a patient with diabetes?

• blood pressure

• BMI

• eyes

• feet

• skin

• neurologic status

what tests are commonly included in the diagnostic workup for diabetes?

• A1C

• full lipid panel

• microalbuminuria

• urinalysis

• EKG

what referrals are commonly needed for a patient with diabetes?

• ophthalmologist (eyes), podiatrist (feet), dietitian

• diabetes educator